How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $4.47 Typical High $4.47 | Professional | None | $2.75 | $4.47 | $4.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $3.72 Typical High $3.98 | Facility | None | $2.95 | $3.72 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $5.75 | Professional | None | $3.24 | $3.24 | $5.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.43 | Professional | RR · Rental | $0.32 | $0.32 | $0.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $3.63 | Professional | UE · Used equipment | $2.40 | $2.40 | $3.63 |
CareSource Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
CareSource Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.80 | Professional | None | $3.31 | $3.31 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $4.27 Typical High $4.37 | Professional | None | $1.62 | $4.27 | $4.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $3.47 Median $912.01 Typical High $2,187.76 | Facility | None | $3.47 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $0.78 Median $3.47 Typical High $4.27 | Professional | None | $0.78 | $3.47 | $4.27 |
United Setting Professional Modifier None Typical Low $1.58 Median $4.90 Typical High $7.94 | Professional | None | $1.58 | $4.90 | $7.94 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.42 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.28 | $0.45 | $0.45 |
Where Indiana sits
The same service costs 5.2 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 45th of 51
$3.24
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.